A comparative study of stretch-and-flow voice therapy versus Smith accent method in rehabilitation of hyperfunctional dysphonia: a randomized controlled trial

Abstract

Background: This work aims to compare between stretch-and-flow voice therapy and Smith accent method of voice therapy in treatment of hyperfunctional dysphonia in order to assess the benefit of using this new technique in its management. A randomized controlled trial was conducted at the Unit of Phoniatrics, Otorhinolaryngology Department, in the period from November 2020 to February 2023. A sample of 60 patients with hyperfunctional dysphonia was randomly divided into two groups; each group consisted of 30 patients: “group A” who received stretch-and-flow voice therapy (SnF) and “group B” who received Smith accent (SA) method of voice therapy. Assessment included auditory perceptual assessment (APA) using modified GRBAS scale and Arabic-voice handicap index (Arabic-VHI). Results: The study revealed significant improvement in grade of dysphonia, voice quality, and Arabic-VHI post-therapy for both groups. There was a significant improvement regarding voice pitch in SnF group only and in loudness of voice in SA group only. Conclusion: SnF can be considered as an alternative approach for treating hyperfunctional dysphonia, offering a shorter duration, and potentially being a simpler alternative for patients who struggle with the more intricate rhythms of the Smith Aaccent voice therapy method.